Early onset menopausal symptoms could predict heart disease

Up to 80 percent of women experience menopausal symptoms, particularly hot flashes and night sweats, at some point during the menopause transition, said Rebecca Thurston, Ph.D., professor of psychiatry, Pitt School of Medicine.

"We used to think these were annoying symptoms that persist for several years around the final menstrual period and simply affect the quality of life for many women," she said. "However, we now know that these symptoms persist far longer and often start earlier than we previously thought. Our research also suggests that for some women, particularly for younger midlife women, menopausal symptoms might mark adverse changes in the blood vessels during midlife that place them at increased risk for heart disease."

The research indicates that early onset of menopausal symptoms is associated with dysfunction of the endothelium, which is the lining of blood vessels. Endothelial dysfunction was measured by assessing flow-mediated dilation (FMD), a noninvasive ultrasound measure of how well the vessel dilates in response to pressure on the wall of the blood vessel.

Dr. Thurston and her colleagues investigated associations between menopausal symptoms and risk for CVD complications among postmenopausal women participating in the National Heart, Lung, and Blood Institute Women's Ischemia Syndrome Evaluation study. A total of 254 postmenopausal women with signs and symptoms of ischemic heart disease were evaluated, and researchers found those who had hot flashes before age 42 to be more likely to have lower FMD, suggesting adverse endothelial changes, as well as higher mortality from heart disease.

"While more work needs to be done to confirm our findings, our research could, one day, help us predict the midlife women who might be at increased risk for cardiovascular disease so that we proactively target these women for early prevention strategies," Dr. Thurston said.